Hot flashes, night sweats, and flushed skin are commonly associated with menopause, the period that marks the end of a woman's reproductive years. To relieve these symptoms, physicians have relied on menopausal hormonal therapy that involves prescribing estrogen and progesterone if the woman has her uterus. If the patient, for some reason, does not have her uterus, she receives estrogen.
Outside of hormonal therapies, physicians have prescribed selective serotonin reuptake inhibitor (SSRI) and selective norepinephrine reuptake inhibitor (SNRI) to help women manage these conditions. Menopausal symptoms (vasomotor symptoms/VMS) affect between 80 and 90 percent of women, according to a May 2017 Journal of Oklahoma State Medical Association.
These symptoms can impact a woman's relationships, sleep, ability to work, and quality of life, requiring the person to seek treatment, usually hormonal therapy. However, not all women can be prescribed hormones or choose not to take this treatment. For instance, women with breast cancer cannot take hormonal therapies, and those who choose not to undergo hormonal treatment do so because of the possible estrogen-linked pathologies, such as endometrial cancer, cardiovascular disease, and breast cancer. In either case, SSRIs and SNRIs have proven to help reduce the VMSs.
To understand why these two antidepressants work, one must revisit both how antidepressants work to treat depression and the processes of the female reproductive cycle. Physicians prescribe SSRIs and SNRIs in conventional medicine for treating depression, anxiety/panic disorders, eating disorders, and insomnia, among other issues. SSRIs and SNRIs work by increasing neurotransmitters in the brain, neurotransmitters being the vehicle by which the brain receives messages.
Researchers have used the antidepressant's ability to increase neurotransmitters to send messages to the brain to regulate body temperature to reduce menopausal conditions. During a woman's reproductive years, estrogen and progesterone work together to regulate the ovulation and reproductive cycle. By menopause, the amount of estrogen and progesterone falls, with estrogen falling significantly.
This drop in hormonal levels affects the hypothalamus, which regulates body temperature. Furthermore, this drastic fluctuation in temperature contributes to the heating and cooling of the body and the subsequent sweating that follows as the body tries to cool itself down. SSRIs and SNRIs can reduce these fluctuations by impacting the levels of neurotransmitters that send messages to the brain to regulate the hypothalamus.
Multiple research studies have shown that SSRIs and SNRIs are effective in reducing the symptoms of menopause. A June 2018 Healthline article cited two studies that said treating women xperiencing menopausal symptoms with SSRIs and SNRIs reduced them.
The 2014 clinical trial found that prescribing low doses of the SNRI Effexor was almost as effective as conventional hormonal treatments in reducing hot flashes. Another clinical trial conducted in 2015 found that low doses of SSRI Paxil effectively improved participants' sleep quality.
In addition to these clinical studies, literature reviews report that SSRIs and SNRIs can significantly reduce the severity of menopausal symptoms. The literature reported that the SNRI desvenlafaxine reduced hot flashes by 62 percent, or seven fewer instances a day, and reduced the severity of those hot flashes by 25 percent. Escitalopram is another SSRI that was proven to reduce the severity of hot flashes by 50 percent in over half of the women using the antidepressant and reduce instances of insomnia by approximately 50 percent.
While using these antidepressants to treat these conditions has positive outcomes, taking SSRIs and SNRIs for menopausal conditions does come with some side effects. The side effects include dry mouth, nervousness, insomnia, restlessness, and nausea.
